Provider Demographics
NPI:1720314263
Name:MCCANN, LORRAINE DIANE (LMHC)
Entity Type:Individual
Prefix:
First Name:LORRAINE
Middle Name:DIANE
Last Name:MCCANN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:LORRIE
Other - Middle Name:
Other - Last Name:MCCANN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMHC
Mailing Address - Street 1:3060 TAMIAMI TRL N
Mailing Address - Street 2:202
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34103-2700
Mailing Address - Country:US
Mailing Address - Phone:239-273-1119
Mailing Address - Fax:
Practice Address - Street 1:3060 TAMIAMI TRL N
Practice Address - Street 2:202
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103-2700
Practice Address - Country:US
Practice Address - Phone:239-273-1119
Practice Address - Fax:239-591-2706
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-18
Last Update Date:2009-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH7000101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ032GOtherBLUE CROSS BLUE SHIELD